Conventional Rehabilitation Therapy Research Articles

Physiotherapeutic Scoliosis-Specific Exercise for the treatment of adolescent idiopathic scoliosis: A systematic review and network meta-analysis.

To compare the rehabilitative efficacy of different physiotherapy scoliosis-specific exercises (PSSE) for adolescent idiopathic scoliosis (AIS) using a network meta-analysis. PubMed, Cochrane Library, Web of Science, EMBASE, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wan Fang Data were searched until October 2023. Meta-analysis and network meta-analysis were conducted using RevMan 5.4 and R4.3.1. This study follows the PRISMA statement and was registered on the PROSPERO platform (No. CRD42022379206). Seventeen RCTs involving 857 patients were included. The meta-analysis showed that PSSE therapy improved Cobb's angle than conventional rehabilitation therapy (standardized mean difference [SMD] = -0.7; 95% confidence interval [CI] = -0.95, -0.44; p = 0.001), angle of trunk rotation (ATR; SMD = -1.05; 95% CI = -1.52, -0.58; p < 0.001), and quality of life (QoL; SMD = 0.61; 95% CI = 0.16, 1.07; p < 0.001). Network meta-analysis showed that Schroth + Scientific Exercise Approach to Scoliosis (SEAS) was the most effective in improving Cobb angle and ATR, while Schroth alone was most effective in improving the QoL. The combination of Schroth and SEAS improved the body posture and trunk deformity in patients with AIS, while Schroth alone improved the QoL. The effectiveness of combining different PSSE techniques supports future evidence-based research on AIS treatment.

Effects of different modalities of transcranial magnetic stimulation on post-stroke cognitive impairment: a network meta-analysis.

The study aimed to evaluate, using a network meta-analysis, the effects of different transcranial magnetic stimulation (TMS) modalities on improving cognitive function after stroke. Computer searches of the Cochrane Library, PubMed, Web of Science, Embass, Google Scholar, CNKI, and Wanfang databases were conducted to collect randomized controlled clinical studies on the use of TMS to improve cognitive function in stroke patients, published from the time of database construction to November 2023. A total of 29 studies and 2123 patients were included, comprising five interventions: high-frequency rTMS (HF-rTMS), low-frequency rTMS (LF-rTMS), intermittent theta rhythm stimulation (iTBS), sham stimulation (SS), and conventional rehabilitation therapy (CRT). A reticulated meta-analysis showed that the rankings of different TMS intervention modalities in terms of the Montreal Cognitive Assessment (MoCA) scores, Mini-Mental State Examination scores (MMSE), and Modified Barthel Index (MBI) scores were: HF-rTMS > LF-rTMS > iTBS > SS > CRT; the rankings of different TMS intervention modalities in terms of the event-related potential P300. amplitude scores were HF-rTMS > LF-rTMS > iTBS > CRT > SS; the rankings of different TMS intervention modalities in terms of the P300 latency scores were: iTBS > HF-rTMS > LF-rTMS > SS > CRT. Subgroup analyses of secondary outcome indicators showed that HF-rTMS significantly improved Rivermead Behavior Memory Test scores and Functional Independence Measurement-Cognitive scores. High-frequency TMS stimulation has a better overall effect on improving cognitive functions and activities of daily living, such as attention and memory in stroke patients.

Effects of CICARE model combined with traditional Chinese medicine encapsulation on muscle strength and depression levels in hemiplegic patients with sequelae of cerebrovascular disease

Objective: To investigate the impact of the combination of CICARE (C - Connect, I - Introduce, C - Communicate, A - Ask, R - Respond, E - Exit) communication model and traditional Chinese medicine (TCM) poultice on muscle strength and depression levels in patients. Methods: Patients were divided into three groups: basic treatment group, basic treatment + TCM poultice group, and combined treatment group. Conventional rehabilitation therapy, TCM poultice external application, and the combination of both with the CICARE communication model were applied in the respective groups. Muscle strength (AMA muscle strength grading scale), self-care abilities (Barthel Index), depression symptoms (Hamilton Depression Rating Scale), neurological deficit status (NIHSS score) and serum inflammatory factor levels were assessed at admission, 3 weeks, and 8 weeks of treatment. Results: After 3 and 8 weeks of treatment, the combined treatment group had higher AMA muscle strength scores and improved Barthel Index scores compared to other groups (P < 0.05). Depressive symptoms also improved significantly in the combined treatment group, with lower HDRS scores at 3 and 8 weeks (P < 0.05). After 8 weeks, IL-1, IL-6, and hs-CRP levels decreased in all groups, with the combined treatment group showing the lowest levels (P < 0.05). NIHSS scores decreased significantly in all groups post-intervention, with the combined treatment group showing the greatest improvement (P < 0.05). Conclusion: The integration of CICARE communication model with TCM poultice shows notable benefits in enhancing muscle strength, daily living self-care abilities, reducing depression, neurological impairment, and inflammatory factors in post-stroke hemiplegia patients.

On-line pilates program as an alternative to conventional rehabilitation therapy for people with multiple sclerosis, pilot study

IntroductionRestrictions in physical activity during Covid-19 pandemic had an impact on exercise activities on people with chronic diseases such as multiple sclerosis, for whom regular exercise is important for managing the disease. Therefore, alternative forms of exercise and rehabilitation were in high demand. The aim of pilot study was to verify the feasibility and potential effect of an online Pilates exercise programme for people with mild to moderate disability due to multiple sclerosis. MethodsThe exercise programme was scheduled for 12 weeks (2 times a week for 45 minutes of Pilates exercise combined with 30 minutes of aerobic activity based on participants preferences).The participants' adherence and the anthropometric parameters (weight, BMI, waist circumference) and the functional tests (Single-Leg Stance Test, Sit to Stand Test) were measured together with the patient reported outcomes to monitor patient's psychological well-being and exercise effect (General Self-efficacy Scale and Activity Balance Confidence Scale). ResultsThe total number of 22 women with multiple sclerosis completed the pilot programme. The exercise program proved to be feasible. After 12 weeks of the online Pilates exercise programme significant improvements were found only in the parameter waist circumference (p = 0.03) and in the functional test Sit to Stance (p = 0.01). For the other tests, despite some improvement (self-efficacy and subjective perceived balance performance), there was no significant statistical difference. ConclusionThe online Pilates exercise programme supervised by a physiotherapist is feasible for people with mild to moderate neurological disability. It seems to have a positive impact on the anthropometric parameters, but this result needs to be evaluated on larger sample of patients.

A Clinical Randomized Controlled Study of Low-Frequency rTMS Therapy on Lower Limb Motor Dysfunction after Stroke

Objective: To investigate the efficacy and safety of low-frequency repetitive transcranial magnetic stimulation (rTMS) for the treatment of lower limb motor dysfunction after stroke. Methods: A total of 96 patients with stroke and lower limb motor dysfunction were enrolled in this study, and were randomly divided into the experimental group and the sham stimulation group using the method of calculator-generated random numbers. Both groups received conventional medication and rehabilitation therapy. The experimental group received 4 weeks of 1 Hz rTMS treatment in the primary cortical motor area (M1) of the healthy side, with the treatment coil tangent to the skull surface; the sham stimulation group underwent the same procedures as the experimental group, but the treatment coil was perpendicular to the skull surface instead. Lower-extremity subscale of the Fugl-Meyer Assessment (FMA-LE), Berg Balance Scale (BBS), gait analysis, and lower-extremity surface electromyography (LESEM) were performed in both groups before and after rTMS treatment. Results: All 96 patients completed the test with no shedding and no adverse reactions. After treatment, the FMA-LE score and BBS score of the 2 groups of patients were significantly improved as compared with the pre-treatment (P &lt; 0.05), and the TUG test time was reduced as compared with the pre-treatment (P &lt; 0.05). The true stimulation group had greater improvement in all assessment indexes than that of the sham stimulation group (P &lt; 0.05). After treatment, the electromyographic activity of the tibialis anterior and rectus femoris muscles in the true simulation group improved significantly. The step length, step speed, and step frequency were also significantly improved in both groups after treatment, and the symmetrical ratio of step length and support time was reduced (P &lt; 0.05). Comparison between the groups revealed that the true simulation group significantly improved after rTMS treatment as compared to the sham stimulation group (P &lt; 0.05). Conclusion: 1Hz rTMS treatment safely and effectively improved motor and balance function in patients with post-stroke lower limb motor dysfunction.

Motor imagery therapy improved upper limb motor function in stroke patients with hemiplegia by increasing functional connectivity of sensorimotor and cognitive networks.

Motor imagery therapy (MIT) showed positive effects on upper limbs motor function. However, the mechanism by which MIT improves upper limb motor function is not fully understood. Therefore, our purpose was to investigate the changes in functional connectivity (FC) within and outside the sensorimotor network (SMN) induced by MIT associated with improvement in upper limb motor function in stroke patients. A total of 26 hemiplegic stroke patients were randomly divided into MIT (n = 13) and control (n = 13) groups. Fugl-Meyer Assessment Upper Extremity Scale (FMA-UL), Modified Barthel Index (MBI) and resting-state functional magnetic resonance imaging (rs-fMRI) were evaluated in the two groups before treatment and 4 weeks after treatment. The efficacy of MIT on motor function improvement in stroke patients with hemiplegia was evaluated by comparing the FMA-UL and MBI scores before and after treatment in the two groups. Furthermore, the FC within the SMN and between the SMN and the whole brain was measured and compared before and after different treatment methods in stroke patients. The correlation analysis between the improvement of upper limbs motor function and changes in FC within the SMN and between the SMN and the whole brain was examined. The FCs between ipsilesional primary motor cortex (M1.I) and contralateral supplementary motor area (SMA.C), M1.I and ipsilesional SMA (SMA.I), and SMA.C and contralateral dorsolateral premotor cortex (DLPM.C) significantly increased in the control group but decreased in the MIT group; while the FC between SMA.C and contralateral primary somatosensory cortex (S1.C) significantly increased in the control group but showed no significant difference in the MIT group. The FCs between M1.I and the ipsilesional hippocampal gyrus and ipsilesional middle frontal gyrus significantly decreased in the control group but increased in the MIT group; while the FC in the contralateral anterior cingulate cortex significantly increased in the MIT group but there was no significant difference in the control group. The results of the correlation analysis showed that the differences in abnormal intra-FCs within the SMN negatively correlated with the differences in FMA and MBI, and the difference in abnormal inter-FCs of the SMN positively correlated with the differences in FMA and MBI. MIT can improve upper limb motor function and daily activities of stroke patients, and the improvement effect of conventional rehabilitation therapy (CRT) combined with MIT is significantly higher than that of CRT alone. CRT may improve the upper limb motor function of stroke patients with hemiplegia mainly through the functional reorganization between SMN, while MIT may mainly increase the interaction between SMN and other brain networks.

Gait Variability and its Relationship to Functional Mobility in Hemiparetic Stroke

Background: Stroke remains a leading cause of long-term disability worldwide, with hemiplegia being one of the most common outcomes, significantly impairing gait and functional mobility. The integration of sensory stimulation techniques into rehabilitation practices offers a promising avenue for enhancing recovery outcomes in hemiplegic stroke survivors. Objective: This study aimed to investigate the effectiveness of auditory and visual sensory stimulation on improving gait parameters and functional mobility in hemiplegic stroke patients. Methods: Conducted at Mayo Hospital, Lahore, this analytical cross-sectional study involved 24 stroke survivors with hemiplegia, randomly assigned to two intervention groups. Inclusion criteria included a Modified Ashworth Scale score of 1 to 1+ and a Mini-Mental State Examination score of ≥25. One group received auditory feedback gait training (AFGT) with smart insoles, while the other engaged in sit-to-stand training with visual feedback using a Wii Balance Board, alongside conventional rehabilitation therapies. The interventions lasted four weeks, with assessments conducted pre and post-intervention. Outcome measures included the Dynamic Gait Index (DGI), Fugl-Meyer Assessment for Lower Extremity (FMA-LE), and various gait parameters. Statistical analysis was performed using SPSS version 25. Results: Post-intervention, the study observed significant improvements in DGI (mean increase: 3.5 points, p&lt;0.01), FMA-LE scores (mean increase: 10 points, p&lt;0.01), and enhanced gait parameters including step length and stride length (p&lt;0.05). The group receiving AFGT with smart insoles showed notable improvements in spatiotemporal gait parameters and balance compared to the control group, indicating the efficacy of sensory feedback in rehabilitation. Conclusion: The study demonstrates that incorporating auditory and visual feedback into rehabilitation regimens can significantly improve gait dynamics and functional mobility in hemiplegic stroke patients. These findings suggest the potential for sensory stimulation techniques to enhance the effectiveness of stroke rehabilitation, advocating for their integration into standard care practices.

The Combined Effect of Robot-assisted Therapy and Activities of Daily Living Training on Upper Limb Recovery in Persons With Subacute Stroke: A Randomized Controlled Trial

ObjectivesTo evaluate the effectiveness of robot-assisted therapy (RAT) followed by activities of daily living (ADL) training in comparison with conventional rehabilitation therapy (CRT) and ADL training in individuals with subacute stroke. DesignA single-blind, 2-arm, parallel-group, open-level, randomized controlled trial. SettingA tertiary care teaching hospital in India. ParticipantsForty-four persons (n=44) with first-ever stroke (in subacute stage) were enrolled from August 2021 to July 2023. InterventionParticipants in the RAT group (n=22) received RAT for 30 minutes, followed by ADL training for 30 minutes. In contrast, participants in the CRT group (n=22) received CRT (30 minutes) followed by ADL training (30 minutes). Both groups received allocated interventions for 15 days over 3 weeks (5 days/week, 3 weeks). Main Outcome MeasuresPrimary outcome: Motor domain score of the Fugl-Meyer Assessment scale for upper extremity (FMA-UE). Secondary outcomes: the other domains scores of FMA-UE (UL -sensation, -joint motions, -joint pain); Modified Ashworth Scale (MAS) (spasticity); hand-function (HF) and ADL-domain scores of the stroke impact scale (SIS); WHOQQL-BREF questionnaires (QOL). Participants were assessed at enrolment and follow-up at 3, 6, and 12 weeks. ResultsPersons who received RAT and ADL training reported significant improvement (P<.05) in UL motor function (mean difference [MD]=3.54;(95% confidence interval [CI]: 1.28 to 5.79]), UL passive joint motions (MD=2.54; [95% CI: 1.56 to 3.52]), SIS-HF (MD=6.37;[95% CI: 4.75 to 7.99]), SIS-ADL (MD=7.13 [95% CI: 3.52 to 8.74]), and in all domains of WHOQOL-BREF (except environmental domain) compared with persons who received CRT and ADL training at 12 weeks. ConclusionsThe findings indicate that RAT followed by ADL training is more effective than CRT followed by ADL training in motor improvement, SIS-HF, SIS-ADL, and QOL at 12 weeks.

Effect of cardiac rehabilitation therapy on depressed patients with cardiac insufficiency after cardiac surgery.

This study aims to analyze the effect of cardiac rehabilitation therapy on cardiac autonomic nervous function in patients with cardiac insufficiency complicated with anxiety depression after cardiac operation to provide a reference for clinical practice. A total of 109 patients subject to cardiac operation in our hospital from January 2020 to March 2023 were enrolled as study subjects, including 50 patients who received conventional rehabilitation therapy (control group) and 69 patients who received cardiac rehabilitation therapy (research group). Before and after treatment, the left ventricular ejection fraction (LVEF) and central venous pressure (CVP) were determined, and the level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) was measured. Low frequency/high frequency (LF/HF), standard deviation of normal to normal (SDNN), and root mean of successive square differences (RMSSD) were measured by a multi-lead ECG system. Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Activity of daily living (ADL), and Barthel Index (BI) were applied for corresponding investigations, as well as the 6-min walk test (6MWT). After treatment, the research group showed higher LVEF, CVP, LF/HF, SDNN, and RMSSD, and lower NT-proBNP, SAS, and SDS than the control group (P < 0.05). Significantly elevated ADL score, BI, and 6MWT and reduced PSQI were observed in both groups after treatment, with more remarkable changes in the research group (P < 0.05). In conclusion, cardiac rehabilitation therapy effectively improved the cardiac function of patients with cardiac insufficiency complicated with anxiety and depression after the cardiac operation and alleviated their negative emotions.

Effects of extracorporeal shock wave therapy combined with isokinetic strength training on spastic calf triceps in patients after a stroke: a double-blinded randomised controlled trial

ABSTRACT Objectives To evaluate the antitetanic effects of extracorporeal shock wave therapy (ESWT) combined with isokinetic strength training (IST) on calf triceps spasm in patients after a stroke. Methods Forty-five patients with hemiplegia after a stroke and lower extremity spasms were randomly assigned into three groups: a control group (n = 15), an ESWT group (n = 15) and an ESWT+IST group (n = 15). All patients agreed to conventional rehabilitation therapy, while the ESWT and ESWT+IST groups received ESWT of 2.0–3.0 bar once a week for four weeks. In addition, the ESWT+IST group underwent four weeks of ankle IST. All groups were assessed using the modified Ashworth scale (MAS) and surface electromyography before and after four weeks of treatment. The ankle passive movement of all groups was measured using the BIODEX isokinetic system at angular velocities of 60°/s, 120°/s, 180°/s and 240°/s. Results After four weeks of treatment, compared with the control group, the ESWT+IST groups showed a significant reduction in MASscores (P = 0.030). The ESWT+IST group had significantly lower MAS scores than the baseline (P = 0.002), while the ESWT group did not show a significant difference (P = 0.072). The average electromyography (AEMG) analysis demonstrated a significant difference among the groups after four weeks (P = 0.001), with the ESWT+IST group having lower AEMG values compared with the control group (P < 0.001) and the ESWT group (P = 0.042). Peak resistive torque significantly decreased in both the ESWT and ESWT+IST groups at all velocities (60°/s: P = 0.030, 120°/s: P = 0.039, 180°/s: P = 0.030 and 240°/s: P = 0.042). Conclusions Extracorporeal shock wave therapy combined with IST can significantly improve calf triceps spasm in patients after a stroke.

A biomedical decision support system for meta-analysis of bilateral upper-limb training in stroke patients with hemiplegia.

The purpose of this study is to investigate the efficacy of bilateral upper-limb training (BULT) in helping people with upper-limb impairments due to stroke or brain illness regain their previous level of function. Patients recuperating from a stroke or cerebral disease were given the option of undergoing BULT or conventional training to enhance their upper-limb function. Participants were randomly allocated to one of the several different fitness programs. Results from the action research arm test, Box and block test, Wolf motor function test, Fugal-Meyer evaluation, and any other tests administered were taken into account. Some researchers have found that exercising with BULT for just 30 min per day for 6 weeks yields significant results. There were a total of 1,411 individuals from 10 randomized controlled trials included in this meta-analysis. Meta-analysis findings revealed that biofeedback treatment outperformed conventional rehabilitation therapy in reducing lower leg muscular strain, complete spasm scale score, electromyography score, and inactive ankle joint range of motion. An analysis of the literature found that BULT improved limb use in people who had suffered a stroke and hemiplegia but it did not provide any additional benefit over unilateral training.

EEG Neuro-markers to Enhance BCI-based Stroke Patients Rehabilitation

Stroke is the second largest cause of death worldwide and one of the most common causes of disability. However, several approaches have been proposed to deal with stroke patient rehabilitation like robotic devices and virtual reality systems, researchers have found that the brain-computer interfaces (BCI) approaches can provide better results. In this study, the electroencephalography (EEG) dataset from post-stroke patients were investigated to identify the effects of the motor imagery (MI)-based BCI therapy by investigating sensorimotor areas using frequency and time-domain features and to select particular methods that help in enhancing the MI-based BCI systems for stroke patients using EEG signal processing. Therefore, to detect the imagined movements that are typically required within conventional rehabilitation therapy with good identification accuracies, the conventional filters and wavelet transform (WT) denoising technique was used in the first stage. Next, attributes from frequency and entropy domains were computed. Finally, support vector machine (SVM) classification techniques were utilized to test the motor imagery (MI)-based BCI rehabilitation. The results demonstrate the capability of the WT denoising technique together with the used features and SVM classifier to discriminate the tested classes of the left hand, right hand and foot MI-based BCI rehabilitation. This study will help medical doctors, clinicians, physicians and technicians to introduce a good rehabilitation program for post-stroke patients.

Effect of Muscle Energy Technique Combined with Conventional Rehabilitation Therapy on Elderly Patients with Knee Osteoarthritis

Effect of Muscle Energy Technique Combined with Conventional Rehabilitation Therapy on Elderly Patients with Knee Osteoarthritis

Effectiveness and electrophysiological mechanisms of focal vibration on upper limb motor dysfunction in patients with subacute stroke: A randomized controlled trial

Upper limb motor dysfunction is a common complication after stroke, which has a negative impact on the daily life of the patients. Focal vibration (FV) has been used to improve upper limb motor function in acute and chronic stroke patients, but its application in subacute stroke patients has not been extensively explored. Therefore, the purpose of this study was to explore the therapeutic effect of FV on upper limb motor function in subacute stroke patients and its underlying electrophysiological mechanism. Twenty-nine patients were enrolled and randomized into two groups: a control group and a vibration group. The control group were treated with conventional therapy including passive and active physical activity training, standing and sitting balance exercises, muscle strength training, hand extension and grasping exercises. The vibration group were given conventional rehabilitation and vibration therapy. A deep muscle stimulator (DMS) with a frequency of 60 Hz and an amplitude of 6 mm was used to provide vibration stimulation, which was sequentially applied along the biceps muscle to the flexor radialis of the affected limb for 10 min, once a day, and 6 times a week. Both groups received treatments for 4 consecutive weeks. In the vibration group, the motor evoked potential (MEP) latency and the somatosensory evoked potential (SEP) latency were significantly shortened (P < 0.05) immediately and 30 min after vibration; the SEP amplitude and MEP amplitude were significantly increased (P < 0.05) immediately and 30 min after vibration. The MEP latency (P = 0.001) and SEP N20 latency (P = 0.001) were shortened, and the MEP amplitude (P = 0.011) and SEP N20 amplitude (P = 0.017) were significantly increased after 4 weeks in the vibration group. After 4 consecutive weeks, the vibration group showed significant improvements in Modified Ashworth Scale (MAS) (P = 0.037), Brunnstrom stage for upper extremity (BS-UE) (P = 0.020), Fugl-Meyer assessment for upper extremity (FMA-UE) (P = 0.029), Modified Barthel Index (MBI) (P = 0.024), and SEP N20 (P = 0.046) compared to the control group. The Brunnstrom stage for hand (BS-H) (P = 0.451) did not show significant differences between the two groups. This study showed that FV was effective in improving upper limb motor function in subacute stroke patients. The underlying mechanism of FV may be that it enhances the efficacy of sensory pathways and induces plastic changes in the sensorimotor cortex.

Comparison of the Modified Barthel Index (MBI) Score Trends Among Workers With Stroke Receiving Robotic and Conventional Rehabilitation Therapy.

Stroke is one of the top causes of adult-acquired disabilities and the fifth most prominent cause of death worldwide. Working-age populations contribute about 40% of the stroke cases which occur annually in Malaysia. The modified Barthel Index (MBI) score has been used for self-care assessment to determine if stroke patients can meet their fundamental needs. The study was designed to compare the trend of MBI scores of workers who had a stroke and underwent robotic rehabilitation therapy to those who had conventional therapy. A cohort study was conducted among workers who had a stroke in northeastern Malaysia. They were assigned either to undergo robotic or conventional rehabilitation therapy. The robotic therapy is performed three times per day for four weeks. Meanwhile, conventional therapy involved walking exercises five days per week for two weeks. Data were collected for both therapies on the admission, at week 2 and week 4. The MBI, modified Rankin Scale (mRS) and Hospital Anxiety and Depression Scale (HADS) trends were examined one month after the therapies. The R (version 4.2.1) (R Core Team, Vienna,Austria) and RStudio (R Studio PBC, Boston, USA) were applied to perform the descriptive analyses on the respective platforms. Repeated measures of analysis of variance were performed to evaluate the outcomes trend and the effectiveness of the two therapies was also compared. A total of 54 stroke patients participated in this study of which 30 (55.6%) of them received robotic therapy. The age of the subjects ranged from 24 to 59 years and the majority (74.1%) were male. Stroke outcomes were evaluated using mRS, HADS, and MBI scores. Except for their age, the individuals' characteristics did not significantly differ between those undergoing conventional therapy and those receiving robotic therapy. After four weeks, it was found that the good mRS had increased, whereas the poor mRS had decreased. Comparing the therapy groups, the MBI scores improved significantly with time, although there were no significant differences between the therapy groups. However, the interaction term between the treatment group (p=0.031) and improvements over time was significant (p=0.001), indicating that robotic was more effective than conventional therapy in improving the MBI scores. For HADS score, there was a significant difference between the therapy groups (p=0.001), with those receiving robotic therapy having higher HADS score. Functional recovery occurs in acute stroke patients when the mean Barthel Index score rises from the baseline (on admission) to week 2 (during therapy)and subsequently on discharge (week 4). Based on these findings, it appears that there was not one therapy superior to the other; nevertheless, robotic therapy may be better tolerated and more effective in certain individuals.

Effects of external diaphragm pacing combined with conventional rehabilitation therapies in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis.

Numerous randomized controlled trials (RCTs) have reported the benefits of external diaphragm pacing combined with conventional rehabilitation therapies (EDP-CRTs) on pulmonary function and exercise capacity in patients with chronic obstructive pulmonary disease (COPD). However, evidence-based regarding its effects remains unclear. This systematic review and meta-analysis aimed to evaluate the effects of EDP-CRTs versus CRTs on patients with COPD. Systematic review and meta-analysis. We performed a systematic review and meta-analysis, searching PubMed, Embase, Cochrane Central Register of Controlled Trials, Scopus, China Biology Medicine Disc, Chinese National Knowledge Infrastructure, Wan-Fang Database, and Chinese Scientific Journal Database from inception to 10 September 2023. RCTs investigating the effects of EDP-CRTs versus CRTs on COPD patients were included. The primary outcome was pulmonary function, including forced expiratory volume in 1 s (FEV1), the percentage of predicted values of FEV1 (FEV1%pred), and FEV1/forced vital capacity (FVC)%. Secondary outcomes included arterial blood gas analysis [the partial pressure of arterial oxygen (PaO2) and the partial pressure of arterial carbon dioxide (PaCO2)]; dyspnea [modified Medical Research Council Dyspnea Scale (mMRC)]; exercise capacity [6-min walking distance (6MWD)]; and quality of life [COPD assessment test (CAT)]. RevMan 5.3 software was used for meta-analysis. The quality of the included studies was assessed using the revised Cochrane Risk of Bias tool for randomized trials (RoB 2.0). The certainty of the evidence was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation system. In total, 13 studies/981 participants were included. The pooled results revealed significant benefits of EDP-CRTs versus CRTs on the FEV1 [standardized mean difference (SMD) = 1.07, 95% confidence interval (CI) = 0.58-1.56], FEV1%pred [weighted mean difference (WMD) = 6.67, 95% CI = 5.69-7.64], the FEV1/FVC% (SMD = 1.24, 95% CI = 0.48-2.00), PaO2 (SMD = 1.29, 95% CI = 0.74-1.84), PaCO2 (SMD = -1.88, 95% CI = -2.71 to -1.04), mMRC (WMD = -0.55, 95% CI = -0.65 to -0.45), 6MWD (SMD = 1.63, 95% CI = 0.85-2.42), and CAT (WMD = -1.75, 95% CI = -3.16 to -0.35), respectively. Planned subgroup analysis suggested that EDP-CRTs had a better effect on FEV1, FEV1/FVC%, 6MWD, and CAT in the duration of 2-4 weeks. EDP-CRTs have better effects on pulmonary function, PaCO2, dyspnea, exercise capacity, and quality of life in COPD patients than CRTs, and the duration to achieve the most effective treatment is 2-4 weeks. This systematic review and meta-analysis protocol was prospectively registered with PROSPERO (No. CRD42022355964).

Analysis of the Influence of Traditional Bone Setting and Loosening Manipulation of Traditional Chinese Medicine on Sports Rehabilitation after Ankle Operation

Objective: To explore the clinical effect of traditional Chinese osteosetting and loosening manipulation after ankle surgery and its influence on rehabilitation. Methods: From September 2022 to March 2023, 70 patients with ankle joint injuries admitted to Longzihu Campus Branch of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine were selected, all of whom received surgical treatment. They were divided into the research group and the control group according to the digital double-blind grouping method, with 35 patients in each group. After the operation, traditional bone setting relaxation and conventional rehabilitation therapy were adopted respectively. The effects of rehabilitation therapy, clinical symptom scores and quality of life of the two groups were compared. Results: The excellent and good rate of the study group was 94.29%, which was significantly higher than that of the control group (77.14%); After treatment, the clinical symptom score of the control group was higher than that of the study group, and the quality of life score was lower than that of the study group (P<0.05), which was statistically significant. Conclusion: The application of traditional Chinese medicine bone setting relaxation method in the postoperative rehabilitation treatment of patients with ankle joint injury can improve the treatment effect, improve the ankle joint function of patients, and accelerate the recovery of patients, which is worthy of promotion.

The Impact of Mental Practice on Motor Function in Patients With Stroke: A Systematic Review and Meta-analysis.

Mental practice (MP), the cognitive rehearsal of physical activities without overt movements, has recently emerged as a promising rehabilitation method for patients with stroke. This paper presents a systematic review and meta-analysis critically evaluating the existing evidence to offer a comprehensive estimate of the overall effect of MP on motor function in stroke patients. A systematic search of 3 international databases (PubMed, Embase, and the Cochrane Library) was conducted for randomized controlled trials. We finally selected 31 randomized clinical trials and conducted meta-analysis to determine the effectiveness of MP on motor recovery of upper extremity, upper extremity function, activities of daily living, and gait velocity in stroke patients. The results of the systematic reviews showed that MP combined with conventional therapy has a positive impact on improving upper extremity motor function, with a moderate quality of evidence. However, the beneficial effect of MP on gait velocity was not demonstrated. It is recommended to treat with MP in addition to conventional rehabilitation therapy to improve the motor outcome of stroke depending on the patient's condition (Recommendation level: Conditional Recommend Evidence certainty: Moderate).

Efficacy of a Hip Brace for Hip Displacement in Children With Cerebral Palsy

There is no consensus on interventions to slow the progress of hip displacement in patients with cerebral palsy. To investigate the efficacy of a novel hip brace in preventing progressive hip displacement in patients with cerebral palsy. This 2-group randomized clinical trial was conducted at 4 tertiary hospitals in South Korea from July 2019 to November 2021. Participants included children aged 1 to 10 years with nonambulatory cerebral palsy (Gross Motor Function Classification System level IV or V). Block randomization was used to assign an equal number of patients to the study and control groups via computerized random allocation sequences. Data were analyzed from November to December 2021. The intervention group wore the hip brace for at least 12 hours a day for the study duration (ie, 12 months). Follow-up evaluations were performed after 6 and 12 months of wearing the brace. Both groups proceeded with conventional rehabilitation therapy during the trial. The primary outcome was the Reimers migration index (MI) on radiography, as assessed by 3 blinded investigators. Primary outcome variables were analyzed using linear mixed models. Secondary outcomes include change in the Caregiver Priorities & Child Health Index of Life with Disabilities, on which lower scores indicate better quality of life. A total of 66 patients were included, with 33 patients (mean [SD] age, 68.7 [31.6] months; 25 [75.8%] boys) randomized to the intervention group and 33 patients (mean [SD] age, 60.7 [24.9] months; 20 [60.6%] boys) randomized to the control group. The baseline mean (SD) MI was 37.4% (19.3%) in the intervention group and 30.6% (16.3%) in the control group. The mean difference of the MI between the intervention group and control group was -8.7 (95% CI, -10.2 to -7.1) percentage points at 6 months and -12.7 (95% CI, -14.7 to -10.7) percentage points at 12 months. The changes in the Caregiver Priorities & Child Health Index of Life with Disabilities were favorable in the study group and reached statistical significance at the 6-month follow-up compared with the control group (difference, -14.2; 95% CI, -25.2 to -3.3). In this randomized clinical trial, the novel hip brace was significantly effective in preventing the progression of hip displacement, compared with the control group. It effectively improved quality of life in patients with nonambulatory cerebral palsy. Therefore, hip brace use could be a promising treatment method to delay hip surgery and improve the quality of life of patients with nonambulatory cerebral palsy. ClinicalTrials.gov Identifier: NCT04033289.

Explanation of issues in "Is scalp-based acupuncture and moxibustion better than conventional rehabilitation therapy for children with cerebral palsy' from the readers?".

Explanation of issues in "Is scalp-based acupuncture and moxibustion better than conventional rehabilitation therapy for children with cerebral palsy' from the readers?".